• Title/Summary/Keyword: Clinical value

Search Result 3,059, Processing Time 0.037 seconds

Parametric Images of Standardized Uptake Values using P-18-FDG Attenuation Corrected Whole Body PET (F-18-FDG감쇠보정 전신 PET을 이용한 표준섭취계수 추정과 매개변수 영상의 구성)

  • Kim, Kyeong-Min;Kwark, Cheol-Eun;Lee, Dong-Soo;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kim, Yong-Jin
    • The Korean Journal of Nuclear Medicine
    • /
    • v.30 no.4
    • /
    • pp.560-569
    • /
    • 1996
  • Background and Purpose : Standardized uptake value(SUV) has been used as a quantitative index for differentiating benign and malignant tumors with F-18-FDG PET In this study, we produced whole body parametric images of SUV(WBPIS) by body weight normalization, and validated the values by comparison with SUV's calculated with regional scans. Subjects and Methods : Whole body scans were followed by regional scans sequentially on 23 patients. In whole body study, transmission and emission scans were acquired for 2 minutes and 6 minutes for each bed position, respectively. In regional study, transmission and emission scans were acquired for 20 minutes. Measured and segmented/ smoothed attenuation correction were applied using these 2 min transmission scans in whole body studies. The effects of attenuation correction on SUVs were evaluated quantitatively using F-18 filled cylindrical phantom. The mean and peak SUVs obtained from WBPIS were compared with SUVs of the regional scans. Results : In phantom studies, with any method of attenuation correction using regional or whole body studies of phantom, SUVs were nearly consistent. In whole body scan, SUV obtained using measured attenuation correction method was a little higher than SUV of regional scan. SUV obtained using segmented/smoothed attenuation correction method was a little lower. In patient studies, WBPIS using segmented/smoothed attenuation correction method was much smoother and more readable. SUVs of WBPIS obtained with both methods of attenuation correction were well correlated with SUVs of regional scans(r=0.9). SUVs of WBPIS with measured attenuation correction method were 5% lower than SUVs of regional scans. SUVs of WBPIS with segmented/smoothed attenuation correction method were 10% lower than SUVs of regional scans. The differences of SUVs of WBPIS by the two attenuation correction methods were relatively small compared with the possible differences derived from biological characteristics of tumors. Conclusion : We concluded that WBPIS could be useful in the quantification of tumor as well as in localization of whole body lesions, which were often outside the field of view in regional scan. WBPIS made using segmented/smoothed attenuation correction method could be used in clinical routines and SUVs from attenuation corrected F-18-FDG PET could be used interchangeably with SUVs of regional studies.

  • PDF

Dipyridamole Induced Transient Left Ventricular Dysfunction in the Tl-201 Gated Myocardial SPECT (Tl-201 게이트 심근 SPECT에서 디피리다몰 부하로 유도된 일시적 좌심실 기능이상)

  • Won, Kyoung-Sook
    • The Korean Journal of Nuclear Medicine
    • /
    • v.37 no.3
    • /
    • pp.153-161
    • /
    • 2003
  • Purpose: Recently the occurrence of dipyridamole stress-induced short term stunning was proven and it is reported that Bland Altman analysis by repeated acquisition Tl-201 gated myocardial SPECT (gSPECT) revealed the 95% limit of agreement for LVEF was 10.3 %. The purpose of this study was to investigate the clinical value of dipyridamole induced transient LV dysfunction on Tl-201 gSPECT. Materials and Methods: Total 93 patients were included and coronary angiography was peformed in all patients less than 2 month from gSPECT. The patients with myocardial infarction were excluded. All patients underwent both dipyridamole stress and 4-h redistribution Tl-201 gSPECT. Forty nine patients of total 93 showed normal coronary arteries (Group 1) and the remaining 44 patients had coronary artery disease (Group 2). We compared LV EF, EDV and ESV during post-stress and 4-h redistribution period calculated by gSPECT using quantitative gated SPECT software and the incidence of dipyridamole induced transient LV dysfunction between group 1 and 2. The criteria for transient LV dysfunction was defined more decrease ${\geq}11%$ of LVEF during post-stress than 4-h redistribution according to previous reported Bland Altman analysis. Results: During post-stress and 4-h redistribution average of 3.1% increment in LVEF, 6.6% increment in LVEDV and 0.7% decrement in LVESV were shown after stress in Group 1, whereas 4.1% decrement, 9.7% increment and 7.2% increment in Group 2 respectively. Dipyridamole induced transient LV dysfunction was only detected in group 2 (18.2%) and not in group 1. It was more frequently observed in triple vessel disease and left main disease (31.8%, N=22) than one and two vessel disease (4.5%, N=22). Conclusion: As with Tc-99m myocardial agent post-stress LV dysfunction was observed in dipyridamole Tl-201 gSPECT. It was only detected in CAD and more frequently occurred in multivessel disease. Thus this finding seems to provide additional information in the diagnosis of coronary artery disease and prediction of prognosis.

The Clinical Effectiveness of Atipamezole as a Medetomidine-Tiletamine/Zolazepam Antagonist in Dogs (개에서 Medetomidine-Tiletamine/Zolazepam 마취에 대한 Atipamezole의 길항 효과)

  • Kwon, Young-sam;Joo, Eun-jung;Jang, Kwang-ho
    • Journal of Veterinary Clinics
    • /
    • v.20 no.3
    • /
    • pp.286-293
    • /
    • 2003
  • The cardiopulmonary and antagonistic effects of atipamezole, to medetomidine (30 ug/kg, IM)-tiletamine/zolazepam (10 mg/kg, IV) were determined. Twelve healthy mongrel dogs ,(4.00$\pm$0.53 kg, mean$\pm$SD) were randomly assigned to the four experimental groups (control, A30; atipamezole 30 ug/kg, A60; atipamezole 60 ug/kg, A150; atipamezole 150 ug/kg) with 3 dogs in each group. Atropine (0.03 mg/kg, IM), medetomidine, and tiletamine/zolazepam (TZ) were injected 10 minute intervals. Atipamezole was injected intravenously 15 minutes after TZ injection. Mean arousal time (MAT) was 52.50$\pm$4.98, 43.06$\pm$2.60, 32.83$\pm$8.13, and 14.36$\pm$1.60 minutes in control, A30, A60, and Al50 groups respectively. In Al50 group, MAT was significantly reduced (P < 0.05). but mean walking time (MWT) was similar to that in control group. In recovery period, the higher doses of atimapezole, the rougher recovery including head rocking, hypersalivation, and muscle twitching. Five of twelve dogs vomited within 5 minutes after medetomidine injection. In Control group, heart rate significantly decreased in all recording stages except 15 minutes after TZ injection, 10 minutes after medetomidine injection in all groups, and 40 minutes after atipamezole injection in A30 group (P < 0.05). In Al50 group, atipamezole reversed the respiratory depression induced by medetomidine. Arterial blood pressure was significantly decreased 10minutes after medetomidine injection and 15 minutes after TZ injection in almost dogs in this study (P < 0.05). From 10 minutes after atipamezole injection to arousal time, arterial blood pressure was progressively increased in A60 and A150 group. Any value of blood gas analysis and CBC, and serum chemistry values were not significantly changed except pH of Al50 at 10 minutes after medetomidine injection. As shown in present study, atipamezole(150 ug/kg) is considered to exert a useful reversal effect in dogs anesthetized with medetomidine-tiletamine/zolazepam combination.

Predictor of IVF Outcomes Following Single Embryo Transfer in Poor Responder Patients (저반응군의 체외수정에서 한 개의 배아 이식 시 임신에 영향을 주는 요인)

  • Kim, Hye-Ok;Kim, Min-Ji;Yeon, Myeong-Jin;Cha, Sun-Wha;Koong, Mi-Kyoung;Song, In-Ok
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.35 no.3
    • /
    • pp.213-221
    • /
    • 2008
  • Objective: To evaluate predictor of IVF outcomes following single embryo transfer in patients with decreased ovarian reserve. Methods: A retrospective review was performed in 919 IVF cycles with elevated basal serum FSH (${\geq}12\;mIU/mL$), the number of retrieved oocytes ${\geq}4$ and serum $E_2$ concentration on hCG day <500 pg/ml between Jan. 1996 and Dec. 2006. Two hundred thirty five IVF cycles following single embryo transfer were included. Pregnancy rates and live birth rates was evaluated according to maternal age, serum $E_2$ on hCG day, basal FSH level, the number of blastomere on day 3 ET, stimulation protocol, the number of cycles of ET. Statistical analysis was used SPSS 12.0 program. Results: OPU cancellation rates were 25.6% (235 cycles), OPU failure rates were 18.5% (170 cycles), embryo transfer cancellation rates were 14.0% (129 cycles). Pregnancy rates following single embryo transfer was 8.1% (19 cycles) and live birth rates was 4.7% (11 cycles). Pregnancy rates and live birth rates of women under 35 years old was statistically higher than those of women above 35 years old (20% vs. 3.5% (p<0.0001), 12.3% vs. 1.8%, (p=0.002)). There was no difference in basal FSH, serum $E_2$ on hCG day, and the number of blastomere on ET, and stimulation protocol. Cumulative pregnancy rates according to the number of cycles of ET were $1^{st}$ 8.1%, $2^{nd}$ 9.2%, $3^{rd}$ 9.7%, $4^{th}$ 9.0%, and $5^{th}$ 9.5%. Conclusion: Pregnancy rates and live birth rates of IVF-ET cycles following single embryo transfer in patients with decreased ovarian reserve are statistically increased in women under 35 yrs old. There is no difference in cumulative pregnancy rates. These data may be helpful for counseling women with decreased ovarian reserve in attempting IVF with their own eggs or when choosing donor oocytes.

The Radiation Therapy for Spinal Cord Compression in Hematologic Malignancy (혈암에서 발생한 척추압박증상의 방사선 치료)

  • Kim In Ah;Choi Ihl Bohng;Chung Su Mi;Kang Ki Mun;Kay Chul Seong;Choi Byung Ok;Jang Ji Young;Shinn Kyung Sub;Kim Chun Choo
    • Radiation Oncology Journal
    • /
    • v.12 no.3
    • /
    • pp.393-399
    • /
    • 1994
  • Spinal cord compression, an oncologic emergency, is a rare complication of hematologic malignancy Our experience was obtained with a series 32 Patients following retrospective analysis for assessing the role of radiation therapy and identifying the prognostic factors affecting on treatment outcome. Diagnosis was usually made by means of radiologic study such as myelography or computerized tomography (CT) or magnetic resonance imaging (MRI) and neurologic examination. Five cases were diagnosed by subjective symptom only with high index of suspicion. In 31 cases, the treatment consisted in radiation therapy alone and the remained one patient had laminectomy before radiation therapy because of diagnostic doubts. Total treatment doses ranged from 800 cGy to 4000 cGy with median of 2000 cGy. Initially large fraction size more than 250 cGy were used in 13 patients with rapidly progressed neurologic deficit. The clinical parameters considered in evaluating the response to treatment were backache, motor-sensory performance and sphincter function. Half of all patients showed good response. Partial response and no response were noted in $37.5\%$ and $12.5\%$, respectively. Our results showed higher response rate than those of other solid tumor series. The degree of neurologic deficit at that time of diagnosis was the most important predictor of treatment outcome. The elapsed time from development of symptoms to start of treatment was significantly affected on the outcome. But histology of primary tumor total dose and use of initial large fraction size were not significantly affect on the outcome. These results confirmed the value of early diagnosis and treatment especially in radiosensitive hematologic malignancy.

  • PDF

The Comparative Analysis of Male and Female of Adult on the Base Crve, Power and Astigamtism of the Cornea (각막의 곡율반경, 굴절력, 난시에 대한 성인 남녀의 비교 분석)

  • Chio, Ho Seong;Kim, Douk Hoon
    • Journal of Korean Ophthalmic Optics Society
    • /
    • v.5 no.2
    • /
    • pp.27-31
    • /
    • 2000
  • As the functional test of cornea. The clinical value of keratometric information was important for assessment the curvature of the cornea, the quality of the corneal surface, the stability of the corneal curvature, and the direction of the corneal astigmatism. This study was performed the comparative analysis of male and female of adult on the base curve, power and astigmatism of the Cornea. On the corneal base curve, the male right eye was 7.656 mm in vertical and 7.966 mm in horizontal. But, the male left cornea was 7.714 mm in vertical base curve and 8.026 mm in horizontal base curve. On the other hand, the female right eye cornea was 7.559 mm in vertical base curve and 7.695 mm in horizontal base curve. But, the female left eye cornea was 7.444 mm in vertical base curve and 7.742 mm in horizontal base curve. On the corneal diopter power, the male right eye was 44.063 diopter in vertical and 43.738 diopter in horizontal. But the male left eye was 44.046 diopter in vertical and 42.304 diopter in horizontal. On the other hand, the female right eye was 44.082 diopter in vertical and 43.77 diopter in horizontal. But, the female left eye was 44.347 diopter in vertical and 43.495 diopter in horizontal. According to the corneal astigmatism axis. The male right eye have 89.9% positive for with the - rule astigmatism, and 8.1 % positive for against - the - rule astigmatism. But, he male left eye have 91.89% positive for with - the - rule astigmatism, and 8.11 % positive for against - the - rule astigmatism. On the other hand, The female right eye have 76.92% positive for with - the - rule astigmatism, and 23.08 % positive for against - the - rule astigmatism. But, the female left have 80.76 % positive for with - the - rule astigmatism, and 17.31 % positive for against - the - rule as tigmatism. The diopter power of corneal astigmatism have 25.57% positive for behind 1 diopter, 44.89% positive for 1 diopter, 18.18% positive for 2 diopter, 5.11% positive for 3 diopter and 6.25% positive for over 4 diopter.

  • PDF

Caregivers' adherence factors affecting maintenance treatment in children with well-controlled asthma : A qualitative analysis through in-depth interview (천식 조절 상태 환아의 유지 치료에 대한 보호자 순응 요인: 심층 면담을 통한 질적 분석)

  • Choi, Ic Sun;Cho, Saeng Koo;La, Kyong Suk;Byeon, Jung Hye;Song, Dae Jin;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.3
    • /
    • pp.364-372
    • /
    • 2010
  • Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

Diagnostic and Therapeutic Utility of Ultrasonography-guided Facet Joint Block in Chronic Cervical Spinal Pain (만성 경추 동통 환자에서 초음파를 이용한 후관절 차단술의 진단 및 치료적 유용성)

  • Kim, Tae Kyun;Shim, Dae Moo;Oh, Sung Kyun;Choi, Byong San;Han, Sang Su
    • The Journal of Korean Orthopaedic Ultrasound Society
    • /
    • v.3 no.2
    • /
    • pp.54-58
    • /
    • 2010
  • Purpose: In patients with chronic cervical pain, the facet joint is the source of the majority. Due to the difficulty of identifying the exact location of the joint that causes these symptoms, the possibility of complications and the placebo effect brings clinical application into question. In this study, we assessed the prevalence of patients with chronic cervical pain and report the diagnostic and therapeutic usefulness of ultrasonography - guided facet joint block therapy. Materials and Methods: Patients with nonspecific chronic cervical pain for more than 6 months were selected. Patients with disc herniation, sciatica-related pain were excluded from the study and 160 patients who failed in conservative treatment (physical therapy, chiropractic therapy, medication) were included in the study. Diagnostic Ultrasonography-guided facet joint block was performed with 1% lidocaine, and after two weeks, Bupivacaine 0.25% was used in patients who tested positive for lidocaine. Patients with more than 75% pain reduction during movement after facet joint block were considered positive. Results: Among the 160 patients with chronic cervical pain, 96 patients(60%) had a positive reaction after facet block using lidocaine. Among the 64 patients with a negative reaction to lidocaine, 48 patients(75%) had a positive reaction to bupivacaine. There were 48 false positive patients(50%) who showed a positive reaction to lidocaine but a negative reaction to bupivacaine. The mean VAS of the total 160 patients before blocks was 8.5, after 2 weeks follow up it decreased to 2.7 (p = 0.001) and after 4weeks 3.6 (p = 0.001). The 8 patients as an initial improvement of symptoms are not satisfied with the procedure and the 3 patients had been worsened during observation, were showed pain relief after additional ultrasonography-guided facet joint block at 4th week. Conclusion: A single ultrasonography-guided block to chronic cervical pain patients has relatively low diagnostic value since high false positive rate. The twice facet joint blocks is thought to be a useful method for interventional pain management of patients with chronic cervical pain.

  • PDF

THE CALCIFICATION TIMING OF THE PERMANENT TEETH BY NOLLA STAGE (Nolla stage에 의한 영구치의 석회화 시기에 대한 연구)

  • Ahn, Sang-Hyun;Yang, Kyu-Ho;Choi, Nam-Ki
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.27 no.4
    • /
    • pp.540-548
    • /
    • 2000
  • The aim of this study was to evaluate the timing of sequence of tooth calcification in current Korean growing children. The Calcification stage of permanent teeth of Korean children was investigated by classifying them into 10 stages by the criteria of Nolla, using the panoramic radiographs of 258 healthy Korean children, 149 males and 109 females, between the ages of 4 years and 13 years, with normal growing tendency and no orthodontic treatment experience. The obtained results were as follows: 1. Timing of calcification of permanent teeth by Nolla stage was established with mean values. Among the mean value, results of Nolla stage 7 were as follows: Calcification timing of male in the maxilla was 6 year 9 month on central incisor, 7 year 4 month on lateral incisor,7 year 9 month on canine, 8 year 8 month on the first premolar, 9 year 4 month on the second premolar, 6 years 3 month on the first molar and 10 year 8 month on the second molar, calcification timing of male in the mandible was 5 year 11 month on central incisor, 6 year 4 month on lateral incisor, 7 year 5 month on canine, 8 year 1 month on the first premolar, 8 year 6 month on the second premolar 5 years 6 month on the first molar and 10 year 3 month on the second molar. Calcification timing of female in the maxilla was 6 year 2 month on central incisor, 6 year 7 month on lateral incisor, 6 year 11 month on canine, 8 year 1 month on the first premolar, 8 year 5 month on the second premolar, 5 years 10 month on the first molar and 9 year 10 month on the second molar, calcification timing of male in the mandible was 5 year 6 month on central incisor, 5 year 9 month on lateral incisor, 6 year 8 month on canine, 7 year 6 month on the first premolar, 8 year 4 month on the second premolar, 5 years 3 month on the first molar and 9 year 7 month on the second molar. 2. The sequence of calcification at Nolla stage 7 was in consequence to the first molar, central incisor, lateral incisor, canine, the first premolar, the second premolar and second molar. 3. While the sequence of root completion of maxilla was in consequence to the first molar, central incisor, lateral incisor, that of mandible was in order of central incisor, first molar and lateral incisor. 4 the calcification timing of permanent teeth was earlier in female than in male (p<0.05). According to above data, the result of this study is applicable for diagnosis and routine clinical practice for children.

  • PDF

An Evaluation of the Accuracy of Mini-Wright Peak Flow Meter (mini-Wright Peak Flow Meter에 의한 PEFR 측정의 정확도)

  • Koh, Young-Il;Choi, In-Seon;Na, Hyun-Ju;Park, Seok-Chae;Jang, An-Soo
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.2
    • /
    • pp.298-308
    • /
    • 1997
  • Background : Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. Methods : The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. Results : The PEFR measured with MPFM was significantly related to the PEFR and $FEV_1$ measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r = 0.92 ; p < 0.001 ; for $FEV_1$, r = 0.78 ; p < 0.001). The accuracy of MPFM was within 100(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being 16.5L/min(percentage of difference being 2.90%) or 10.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or 20.49~+9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p > 0.05) and the coefficient of variation($2.4{\pm}1.2%$) of PEFR measured with MPFM was significantly lower than that($5.2{\pm}3.5%$) with standard pneumotachygraph in normal (p < 0.05). Conclusion : This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.

  • PDF